| NPI | 1790811669 |
|---|---|
| Doing Business As | MAIN STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANDREW A SMITH Owner 209-827-9226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA c42233) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA c43678) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-11-19 |